In 2000, the federal government set its sights on eliminating racial disparities in infant mortality rates by 2010.

Things aren’t going exactly as hoped.

Before their first birthday, black infants in California are still twice as likely to die as infants in any other racial group, a statistic that galvanized the California Department of Public Health to declare Feb. 17-23 “Black Infant Health Week.”

“While what we’re doing is pretty good, it’s not good enough,” said Catherine Camacho, deputy director of the Center for Family Health in the state’s Department of Health Services.

“We have to look deeper at what’s going on, because we really need to turn this around,” Camacho said. “This is just not acceptable.”

In 2000, the federal government launched the Healthy People 2010 initiative, setting benchmarks for a number of health goals for the nation’s population, including reducing infant mortality rates among all races to 4.5 deaths per 1,000 births by 2010.

While average infant mortality rates had been steadily falling up to that point _ from 12.6 deaths per 1,000 births to 6.9 deaths per 1,000 births between 1980 and 2000 _ the gap between black and white mortality rates actually widened during those years, according to the U.S. Centers for Disease Control and Prevention.

And in 2004, there were still 13.6 black infant deaths nationwide for every 1,000 births, compared with 5.7 deaths per 1,000 among white newborns. Hispanics babies fared even better, with 5.5 deaths per 1,000 births in 2004, according to the CDC. Among Asian newborns in the United States, 4.5 infants out of 1,000 didn’t survive their first year.

In California, the rates are slighter better, noted Shabbir Ahmad , acting chief of maternal and child health programs for the Department of Public Health. In 2004, California tied with Utah in having the sixth-lowest infant mortality rates nationwide.

The gap between blacks and other racial groups persists, the CDC states, due in large part to a two- to three-fold increased risk of black infants being born with “low birth weight” (5 pounds, 8 ounces or less) or “very low birth weight” (3 pounds, 5 ounces or less).

Other factors leading to infant mortality include respiratory distress, sudden infant death syndrome and birth defects.

Access to health care and lifestyle habits play a significant role in reducing infant mortality, and government programs focus on increasing the quantity and quality of care for black women, as well as supporting healthful lifestyle choices.

But social factors also have a major role, experts point out.

“There are so many factors that play into those disparities,” said Dr. Anand Chabra, director of the maternal and child health program for San Mateo County, where infant mortality rates among blacks declined more than 50 percent between 1990 and 2004.

“Some of it is access to care, and some of it is racism,” he said.

A 2001 study from the CDC – titled “A Public Health Framework for Addressing Black and White Disparity in Preterm Delivery” – emphasized that the stress of low socioeconomic status and racism plays a critical role in the gap.

“African-American women experience some stressors not experienced by women of other ethnic groups,” they wrote, “including racism and the interacting effects of gender and racism.”

The cumulative effect of those stresses is that black women more often struggle with feelings of anger, hopelessness, anxiety and depression, the authors said.

And studies link chronic stress to the stimulation of hormones that induce early labor, the study noted. Stress is also associated with higher rates of bacterial vaginosis, an infection that is three times more common in blacks than whites during pregnancy and may increase the risk of premature delivery.

“Stress is a major factor,” agreed Ahmad.

The state, which also oversees numerous county-run programs supporting black infant health, takes a multifaceted approach in tackling the challenge of reducing the disparity in infant death rates, said Camacho, with the state’s Center for Family Health.

One approach taken by the San Mateo County program, for example, focuses on teaching women to overcome the demoralizing effects of discrimination and financial hardship, said Chabra.

“One of the models we use is social support and empowerment,” he said.

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